Fitness: Pedalling in pain? Here's why

Jill Barker, Postmedia News07.14.2014

Hannah Parish gets fitted on a road bike at a shop in Toronto. Some bikes are fit for comfort, while others are fit for performance, which muddies the waters when it comes to linking bike fit to injuries.

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Unlike runners who have a reputation for being injury-prone, cyclists tend to be healthier. Or so we’ve been led to believe. Yet, even though cyclists don’t pound the pavement, they, too, suffer their fair share of aches and pains.

Also unlike runners, who have countless experts offering an opinion on running injuries, the cycling community is far less invested in the cause of their aches and pains. In fact, most statistics highlight injuries incurred from bike collisions and offer little insight into the type of injuries incurred by spending time in the saddle.

This lack of knowledge about the cause of cycling injuries is surprising considering the number of cyclists on the roads. It’s for this reason that a research team out of the Courage Kenny Sports and Physical Therapy Center in Minneapolis decided to study a group of road cyclists to find out whether variables like bike fit, training volume and biomechanics play a role in the cause and/or prevention of injuries.

To be considered for the study, cyclists had to be between 18 and 60 years of age, have at least one year’s experience on the bike and consider cycling to be their primary sport — multi-sport athletes were excluded. Sixty-three cyclists were included in the study, all of who logged their training habits over a two-week period, detailed past and present injuries and participated in a series of tests including evaluating strength, flexibility and bike fit.

The mean age of the group was 41, with 46 of the 63 cyclists male. They had, on average, 17.5 years of cycling experience with 78 per cent using bikes that were at least five years old. All but one wore a helmet whenever they were in the saddle and 59 per cent had their bikes professionally fit.

As for their training habits, the cyclists averaged 4.6 days a week on their bike, accumulating just over 10 hours in the saddle and logging almost 209 kilometres weekly.

Interestingly, 69 per cent of cyclists began the study with a pre-existing injury and/or pain, 65 per cent of whom had been nursing their injury for at least a year. More than half reported pain in two or more locations, with the neck, shoulder, lower back and knee the most frequent sites of injury.

Despite the rate of injury among the study subjects, the researchers failed to pinpoint differences in the training patterns or biomechanics of those who were injured and those who weren’t. Training volume was comparable among cyclists as was flexibility and strength, all of which seemed to play little role in predicting injury.

As for bike fit, which is often the first variable evaluated when cyclists complain of pain, the study actually found a higher rate of injury among those who had a professional bike fitting as compared to those who didn’t. The researchers suggest this surprising phenomenon is probably the result of an increased tendency for cyclists to seek out a professional bike fitter when they’re injured and the inability of a perfectly fit bike to alleviate all pre-existing pain. They also alluded to the possibility that, because more than half the cyclists in the study had been professionally fit more than three years earlier, cycling biomechanics may change over time.

There are other elements about bike fitting to consider. There’s no standardized procedure for fitting a cyclist to a bike, allowing for lots of variation between fitters. Also, some bikes are fit for comfort while others are fit for performance, which further muddies the waters when it comes to linking bike fit to injuries.

Another important finding in the study was the tendency for cyclists to train through pain, which makes them a member of the not-so-exclusive club of fitness fanatics who put off seeking medical advice until pain makes it almost impossible to carry on. In this particular study, which was accepted for publication in the Clinical Journal of Sports Medicine in March 2014, the cyclists reported seeking medical attention only when they were no longer able to keep up with their teammates.

Admittedly, the age of the cyclists in this study suggests that they may be more prone to injury than their younger counterparts, but the data offers a fair snapshot of the type of recreational cyclist riding on roads all across the country. And while there’s no consensus as to what types of training strategies can reduce the risk of injuries, it’s likely that pain from cycling is the result of multiple factors including training habits, bike fit, age, gender, strength and joint mobility.

For the average injured cyclist, then, it’s worthwhile making changes one variable at a time to see if pain abates. It’s also worthwhile heading to your local bike shop if it has been a while since your bike was professionally fit. Finally, don’t wait to seek medical advice. Subjects who started the study nursing an injury were significantly more likely to experience new aches and pains, so deal with pain early or suffer the consequences later.

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